Chronic Care Management in Delaware.
Non-face-to-face care coordination for patients with multiple chronic conditions. Medicare billing, Delaware Medicaid coverage, and compliance details for Delaware providers.
How does CCM work for providers in Delaware?
Chronic Care Management (CCM) enables Delaware providers to bill Medicare for non-face-to-face care coordination using CPT codes 99490, 99491, 99439. Patients with two or more chronic conditions qualify — common combinations in Delaware include heart disease, diabetes, hypertension. Medicare covers CCM federally for patients with 2+ chronic conditions. Delaware Medicaid provides partial supplementary coverage. Serving 0.2M seniors with +18% by 2035 projected growth, Delaware's CCM market is expanding. CCN Health manages clinical workflows, care plan documentation, and monthly billing — integrating with 4+ major health systems including ChristianaCare and Bayhealth running CCM programs.
Medicare Billing
CCM billing in Delaware.
CCM uses federally standardized CPT codes with uniform reimbursement across Delaware. Delaware Medicaid provides partial supplementary Medicaid coverage for dual-eligible patients.
CCM services, first 20 min of clinical staff time per month
CCM services requiring physician/QHP, first 30 min/month
Each additional 20 min of CCM clinical staff time
~$80-$130/mo per patient
20 minutes of non-face-to-face care coordination per month (99490); 30 minutes for complex CCM (99491)
Medicare covers CCM federally for patients with 2+ chronic conditions. Delaware Medicaid provides partial supplementary coverage.
Billing Requirements
Patient must have two or more chronic conditions expected to last at least 12 months
Comprehensive care plan must be established and maintained
Patient consent documented in medical record
24/7 access to care team required
Continuity of care with designated practitioner
Delaware Medicaid Supplement
Delaware Medicaid provides partial supplementary coverage — check current Delaware Medicaid fee schedules for dual-eligible CCM rates.
Regulatory Landscape
CCM compliance in Delaware.
Beyond federal Medicare requirements, Delaware has specific telehealth, licensure, and privacy regulations that affect CCM programs.
Interstate Licensure
- *Delaware is not currently a member of the Interstate Medical Licensure Compact. Providers delivering CCM services must hold a valid Delaware medical license.
EHR Integrations
CCM-compatible EHRs.
Major Delaware health systems like ChristianaCare and Bayhealth use EHR platforms that CCN Health integrates with. Each integration includes automated CCM documentation, billing, and clinical workflows.
PointClickCare
889 integration guides
ALIS
887 integration guides
Ethizo
240 integration guides
athenahealth
240 integration guides
Charm Health
240 integration guides
MatrixCare
240 integration guides
Epic
240 integration guides
August Health
240 integration guides
FAQ
CCM in Delaware questions.
Delaware's mix of urban centers and rural communities means CCM serves both high-volume practices affiliated with systems like ChristianaCare and Bayhealth and remote clinics where in-person visits are difficult. Delaware Medicaid offers partial supplementary coverage for dual-eligible patients. High prevalence of heart disease, diabetes, hypertension among Delaware's patient population drives CCM enrollment.
Delaware Medicaid provides partial supplementary coverage for CCM services. Medicare covers CCM federally for patients with 2+ chronic conditions. Delaware Medicaid provides partial supplementary coverage. For dual-eligible beneficiaries, providers can bill both Medicare and Medicaid to maximize reimbursement.
With 0.2M residents aged 65+, Delaware has a large CCM-eligible population — patients with two or more chronic conditions. Common multi-morbidity combinations in Delaware include heart disease with diabetes, and hypertension with heart disease. Delaware's +18% by 2035 senior population growth means CCM demand is accelerating.
Delaware has approximately 0.2M residents aged 65+ (19% of the population), with +18% by 2035 projected growth. Small state with high senior population concentration. ChristianaCare dominates the market. Beach communities in southern Delaware have growing retirement populations.
CCM in Delaware must comply with federal Medicare billing requirements and HIPAA. Delaware does not currently have a comprehensive state privacy law beyond HIPAA, but standard patient consent and data security requirements apply. Delaware is not part of the Interstate Medical Licensure Compact — providers must hold a valid Delaware license to deliver CCM services. Delaware has telehealth parity. Medicaid covers remote monitoring through managed care organizations.
This page provides general informational guidance only and does not constitute legal, compliance, or billing advice. Telehealth regulations, Medicaid coverage, and state privacy laws change frequently. Verify current requirements with your state health department, payers, and qualified healthcare compliance counsel before making program decisions. Demographic data is based on U.S. Census Bureau estimates. Data last verified: March 2026.
Other Programs
More programs in Delaware.
Explore other Medicare remote care programs available to Delaware providers.
RPM
Remote Patient Monitoring
Real-time vital sign monitoring with FDA-cleared cellular devices.
PCM
Principal Care Management
Focused management of a single high-complexity chronic condition.
BHI
Behavioral Health Integration
Behavioral health screening and collaborative care in primary care settings.
RTM
Remote Therapeutic Monitoring
Therapy outcome monitoring for musculoskeletal and respiratory rehabilitation.